Introduction to Pharmacology

Which patient would be at highest risk for an adverse drug reaction?

84-year-old patient with diabetes, heart failure, and hypertension who takes seven prescription medications each day

A patient is prescribed cefazolin. It is most important for the nurse to teach the patient to avoid which substance while taking cefazolin?

Alcohol

Which statement about allergic reactions to penicillin does the nurse identify as true?

Anaphylactic reactions occur more frequently with penicillins than with any other drug.

A patient asks you about the difference between a generic drug and a brand name drug. You explain that a generic drug (Select all that apply).

Is usually cheaper than the brand Has the same chemical composition as the brand May have several brand names

A nurse is reviewing medication dosages and factors that influence medication metabolism. Which of the following factors should the nurse identify as a reason to administer lower medication dosages? (select all that apply)

Liver FailureConcurrent use of medication the same pathway metabolizes

A nurse is preparing a client's medications. Which of the following actions should the nurse take in following legal practice guidelines?

Teach the client about the medication Monitor for adverse effects Lock compartments for controlled substances

Levofloxacin should be discontinued immediately if what happens?

Tendon pain or inflammation develops.

The nurse is reviewing laboratory values from a patient who has been prescribed gentamicin. To prevent ototoxicity, it is most important for the nurse to monitor which value (s)?

Trough drug levels of gentamicin

Which therapeutic use is Isoniazid (INH)?

Tuberculosis

A patient is about to start taking Trimethoprim/ Sulfamethoxazole (Bactrim) to treat a UTI. You should instruct the patient to report which of the following possible indications of serious adverse effect of this drug?

Sore throat

Which therapeutic use is for Amphotericin B?

Systemic candidiasis

A patient is prescribed ketoconazole to treat systemic mycoses. You should include which of the following when instructing the patient about taking this drug?

Take it with food to reduce gastric distress, take it with 8 oz of orange juice to increase absorption

Which therapeutic use is Acyclovir (Zovirax)?

Viral Infection

When a generic form of a brand medication is being approved for use, it must demonstrate to the FDA (Food and Drug Administration) that it is _________________________________ when compared to the brand product.

bioequivalent

Which therapeutic use is for Vancomycin?

mrsa

A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a half-life of 36 hours. How many times per day should the nurse expect to administer this medication?

one

a nurse is reviewing a drug handbook prior to adminsisteing a drug to a client who has kidney disease, the handbook states that the drug can be administered but identifies certain risks

precautions

client is prescribed amoxicillin to treat an ear infection. the health care provider provider instructs the client to monitor and report which of the the following

rash

a nurse is reviewing drugs in a drug reference. the nurse should identify that dugs in the same class share which of the following similarities

they have the similar mechanisms of action

You are administering gentamicin for treatment of a respiratory tract infection. Instruct the patient to monitor and report which of the following adverse effects of gentamicin?

tinnitus

A nurse is reinforcing discharge teaching with a client who has a new prescription for transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands the instructions?

"I will apply the patch to an area of skin with no hair."

A nurse is providing discharge instructions for a client who has a new prescription for an antihypertensive medication. Which of the following statements should the nurse give?

"Change positions slowly when you move from sitting to standing."

The 17-year-old client is prescribed metronidazole and erythromycin for a persistent Chlamydia infection. Which statements by the client indicate the need for further teaching? Select all that apply.

"I can have a beer or two while taking these medications." ."My birth control pills will still be effective while taking these medications."

A patient is prescribed an antibiotic to treat a urinary tract infection. What statement by the patient indicates a need for further teaching?

"I can stop the medication as soon as the symptoms have disappeared."

The nurse cares for a patient taking a calcium channel blocker for hypertension. The nurse is most concerned if the patient makes which statement?

"I drink a glass of grapefruit juice each evening."

The nurse teaches a patient who has a gastric ulcer about cimetidine (a histamine H2 antagonist). The nurse should include which information about antagonists in the patient's instructions?

An antagonist prevents receptor activation in the stomach.

A nurse is caring for a client who is taking oral oxycodone. The client is also taking ibuprofen in three recommended daily doses. The nurse should identify that an interaction between these two medications will cause which of the following findings?

An increase in the expected therapeutic effect of both medications

A nurse is preparing to administer eye drops to a client. Which of the following actions should the nurse take? (select all that apply)

Ask the client to look up at the ceilingDrop the medication into the center of the clients conjunctival sacInstruct the client to close her eye gently after instillation

A patient is prescribed a medication that is potentially hepatotoxic. What should the nurse assess before administering the medication?

Aspartate aminotransferase and alanine aminotransferase

A patient is prescribed doxycycline. If the patient complains of gastric irritation, what should the nurse do?

Give the patient food, such as crackers or toast, with the medication

You are helping a patient learn how to give himself an insulin injection. Which of the following is the best method for evaluating effective learning?

Have the patient demonstrate an insulin injection.

The nurse collects in the health history information that the patient is taking an over-the-counter medication. Which of the following statements is true about over-the-counter agents?

They do not require supervision by a health care professional.

A patient asks you about the difference between a generic drug and a trade- or brand-name drug. You explain that a generic drug (Select all that apply.)

-has the same chemical composition as the brand-name drug. -may have several brand names. -is usually less expensive than a brand-name drug.

Which statement about superinfections does the nurse identify as true?

. Superinfection is defined as a new infection that appears. during the course of treatment for a primary infection.

A nurse is assessing a client before administering medications. Which of the following data should the nurse obtain? (Select all that apply.)

A. Use of herbal products C. Ability to swallow E. Allergies

A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about apotential contraindication to a medication for which of the following clients? (Select all that apply.)

B. A client who takes Prednisone and has a possible Fungal infectionC. A client who has chronic liver disease and is taking Hydrocodone E. A client who has a prosthetic heart valve, takes Warfarin, and reports a suspected pregnancy

A patient with a history of a severe anaphylactic reaction to penicillin has an order to receive cephalosporin. What should the nurse do?

B. Contact the health care provider for a different antibiotic.

A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states when they took penicillin 3 years ago, they developed a rash. Which of the following actions should the nurse take?

B. Withhold the medication

A nurse on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness?

C. reduced hepatic function

A nurse is preparing to administer a drug to a client. In which of the following sections of a drug handbook should the nurse look to determine if the client can receive the drug?

Contraindications

A nurse is evaluating the kidney function of an 82-year-old patient before the administration of medications. Which laboratory result would provide the best index of renal function?

Creatinine clearance

A nurse is evaluating the kidney function of an 85-year-old patient before the administration of medications. Which laboratory result would provide the best index of renal function?

Creatinine clearance

Which therapeutic use is Cephalexin (Reflex)?

Gram positive infection

A patient is prescribed vancomycin orally for antibiotic- associated pseudomembranous colitis. The nurse will monitor the patient for what?

Ototoxicity

The patient is being discharged with continued ciprofloxacin therapy. When providing discharge teaching, the nurse should advise the patient to call the healthcare provider immediately if what develops?

Pain in the heel of the foot

A nurse is caring for a client who was prescribed an antidepressant based on its ability to prevent the reuptake of neurotransmitters. The nurse should identify that which of the following terms describes why this drug was prescribed for the client?

Pharmacologic action

An older adult patient may be at risk for drug toxicity due to which of the following physiologic changes associated with aging?

Reduced hepatic blood flow

Administering two medications for hypertension that will both lower blood pressure is most likely an example of:

Relative contraindication

A patient is prescribed oral Tetracycline for treatment of acne vulgarisms. When telling the patient about taking Tetracycline, which of the following instructions should you include?

Report mouth pain, take it 1 hr before meals, wear sunscreen and protective clothing

A nurse is caring for a client who is receiving nitroglycerin IV and is switching to the oral form of the drug. The nurse should identify that the oral dose will be higher than the IV dose for which of the following reasons?

The oral form has decreased bioavailability because of the first-pass effect

A nurse is caring for a client who is taking diphenhydramine for insomnia and reports drowsiness. The nurse should identify that drowsiness indicates which of the following?

Therapeutic effect Drowsiness is a therapeutic effect of diphenhydramine for a client who is taking the drug to treat insomnia.

A patient who was taking sulfonamides develops Stevens-Johnson syndrome. Upon assessment, the nurse expects to find what?

Widespread skin lesions

A patient has been prescribed oral ciprofloxacin for a skin infection. When administering the medication, it is most important for the nurse to do what?

Withhold antacids and milk products for 2-4 hours before or 2 hours afterward

A nurse is reviewing a client's health record and notes that the client experienced permanent extrapyramidal effects caused by a previous medication. The nurse should recognize that the medication affected which of the following systems in the body?

central nervous

A nurse is caring for a client who is taking acetaminophen and codeine for pain relief. These analgesic drugs interact with one another to cause an additive effect. The nurse should identify that which of the following are characteristics of additive drug interactions? (

clients can achieve desired effects with the use of lower dosages both drugs have similar actions

a nurse is teaching a client about naproxen enteric coated tablets. Which of the following statemens should the nurse include in the teaching?

do not crush or chew the tablet

A nurse is caring for a client who has a history of renal insufficiency and is taking lithium. The nurse should monitor the client for which of the following?

drug toxicity

a patient is having difficulty remembering to take a prescribed drug three times a day. What form of the drug should the health care professional recommend to increase adherence?

extended release

a nurse is providing teaching to a pregnant client who is taking captopril an ace inhibitor, to treat HTN. The nurse informs the client that captopril is a tetrogenic drug. the nurse should explain that tetrogenic drugs can cause which

fetal malformation

Which therapeutic use is Ketoconazole?

fungal infection

what to monitor with rifampin

jaundice

A patient is prescribed a medication to be taken on an empty stomach. Which directions should the nurse provide to the patient?

"Take the medication 1 hour before eating."

A nurse is reviewing a client's prescribed medications. Which of the following situations represents a contraindication to medication administration?

A medication is approved for ages 12 and older, and the client is 8 years old

A nurse is preparing to administer digoxin to a client who states, "I don't want to take that medication. I do not want one more pill." Which of the following responses should the nurse make?

"Tell me your concerns about taking this medication."

A nurse is teaching a client about the adverse effects of digoxin. which of the following statements should the nurse include in the teaching?

"contact your provider if adverse effects occur."

A nurse is obtaining a client's health history. The client reports no allergies but has experienced mild itching while taking amoxicillin in the past. Which of the following responses should the nurse make?

"itching can indicate hypersensitivity to amoxicillin.

Primary care providers prescribe drug dosages for children using which of the following information? (Select all that apply.)

-Body surface area -Age -Weight -Drug properties

A patient who has a peanut allergy comes to the emergency department with suspected anaphylactic shock. Which of the following actions should you anticipate taking? (Select all that apply.)

-Initiate oxygen therapy to support respiratory function. -Administer epinephrine to increase blood pressure. -Give diphenhydramine to stop histamine release. -Establish and maintain an open airway to ensure oxygenation.

The nurse teaches a patient about a sustained-release capsule. Which statement by the patient requires an intervention by the nurse?

A."I will take this medication 4 times a day."

The clinic nurse receives a phone call from a patient. The patient tells the nurse that he forgot to take his medication this morning. Which response by the nurse is best?

A."What is the name of the medication?"

A nurse is preparing to administer epinephrine to a patient who is having a severe allergic reaction. Which route of administration should the nurse use to provide the fastest and most complete absorption of epinephrine?

A.Intravenous

An older patient with hypertension is prescribed enalapril, a drug that is eliminated by the kidneys. Before the patient begins the drug, the health care professional should assess which of the following?

A.Serum creatinine

Which data indicates the antibiotic therapy has NOT been effective for a client diagnosed with bacterial pneumonia?

A.The client is expectorating thick, green sputum

The client who had an elective cholecystectomy is receiving a prophylactic antibiotic. Which information indicates the medication is not effective?

A.The clients WBC count is 18,000

A nurse is caring for a client who is newly admitted to the facility for chest pain. At which of the following times should the nurse begin teaching about drugs and discharge planning?

ASAP

A patient's liver function can be estimated using which of the following laboratory markers?

AST and ALT

Administering penicillin to a patient with a history of anaphylaxis to penicillin-type drugs is an example of a(an):

Absolute contraindication

You note that a primary care provider prescribed morphine sulfate, an opioid agonist, to relieve a patient's postoperative pain. Which of the following describes the action of an agonist on a receptor?

Activates the receptor

A nurse is preparing to administer medications to a 4-month-old infant. Which of the following pharmacokinetic principles should the nurse consider when administering medications to this client? (select all that apply)

B. infants have immature liver functionC. infants blood-brain barrier is poorly developedD. infants have an increased ability to absorb topical medications

Postmarketing surveillance of a newly FDA approved medication may result in the identification of a:

Blackbox warning

A nurse is working with a newly licensed nurse who is administering meds to clients. Which of the following action should the nurse identify as an indication that the newly hired nurse understands medication error prevention?

Checking the prescription when a single dose requires administration of multiple tablets

A nurse is speaking to a client who is taking sertraline and reports drinking grapefruit juice. The nurse explains that grapefruit juice inhibits an enzyme in the liver that is used to metabolize sertraline. The nurse should recognize the client's risk for which of the following?

Drug toxicity

A nurse is preparing to teach a client how to take care of a newly created colostomy. the nurse should identify that which of the following factors can decrease the clients ability to learn

Impaired cognitive level Language barrier Discomfort Unreadiness to learn

A nurse is caring for a client who arrived at an emergency department following a bee sting. Which of the following findings indicates an anaphylactic reaction? (select all that apply)

Low blood pressure is correct. Anaphylaxis is an immediate and life-threatening allergic response, manifesting as bronchospasm, laryngeal edema, and a rapid drop in blood pressure. Immediate treatment with epinephrine and IV fluids is imperative. Wheezing is correct. Anaphylaxis is an immediate and life-threatening allergic response, manifesting as bronchospasm, laryngeal edema, and a rapid drop in blood pressure. Wheezing is an indication of bronchospasm and is treated using bronchodilators. Difficulty swallowing is correct. Anaphylaxis is an immediate and life-threatening allergic response, manifesting as bronchospasm, laryngeal edema, and a rapid drop in blood pressure. Difficulty swallowing is an indication of laryngeal edema and, therefore, anaphylaxis.

Which therapeutic use is for Chloroquine?

Malaria

A nurse reviewing a clients medical record notes a new prescription for verifying the trough level of the clients medication. Which of the following actions should the nurse take?

Obtain a blood specimen immediately prior to administrating the next dose of medication

A nurse is providing teaching for a client who has a new prescription for a drug with a high potential for toxicity. Which of the following information should the nurse include? (select all that apply)

Periodic laboratory tests are essential to measure serum drug levels is correct. Clients who are taking drugs that have a high potential for toxicity should undergo regular monitoring of serum drug levels to be certain the drug level stays within the therapeutic range. Monitoring for indications of toxicity is important is correct. Drugs that have a high potential for toxicity can quickly build up to toxic levels in the blood, resulting in effects that can be irreversible or life-threatening. Therefore, the nurse should monitor for manifestations of toxicity particular to the drug the client is taking. Taking the smallest effective dose is crucial is correct. It is optimal to use the lowest effective dose of a drug to achieve therapeutic effects because doing so helps minimize the risk for toxicity.

When the nurse informs the patient that she is giving him a beta-blocker, she is providing the ___________________________________ of the drug.

Pharmacologic classification

Be sure to administer imipenem-cilastatin (Primaxin) cautiously with patients who have which of the following?

Seizure disorder

A patient with glaucoma asks you about taking oxybutynin (Ditropan), a muscarinic antagonist, to manage an overactive bladder. You explain that glaucoma is a contraindication for taking oxybutynin. Patients should not take a drug that is contraindicated because of its potential for which of the following?

Serious adverse reactions

A patient is prescribed cefixime. The nurse should teach the patient to immediately report any signs of what?

Skin rash, hives, or itching

A nurse is caring for a client who is postpartum and breastfeeding. The client asks the nurse about the effects that taking over-the-counter drugs will have on her newborn. Which of the following should the nurse consider when recommending a drug for the client? (select all that apply)

The newborn's weight is correct. The nurse should consider the weight of the newborn when recommending a drug for a client who is breastfeeding. The lower the newborn's weight, the greater the effects of the drug absorbed via breastmilk will be to the newborn.How much breast milk the newborn consumes each day is correct. The nurse should consider the amount of breast milk the newborn consumes per day when recommending a drug for a client who is breastfeeding. The more breast milk the newborn consumes, the more of the drug is likely to be absorbed into the newborn's circulation.Whether or not the benefits to the client outweigh the risks to the newborn is correct. The nurse should weigh the benefits against the risks when recommending a drug for a client who is breastfeeding. If the benefits will be minimal, it is generally not worth the risk to the newborn.The properties of the drug is correct. The nurse should consider the properties of the drug when recommending a drug for a client who is breastfeeding. Certain drugs can transfer more easily into breast milk, depending on properties like fat solubility.

A nurse is obtaining a client's health history and discovers that the client takes loratadine, an over-the-counter drug. The nurse should identify that which of the following is correct regarding the over-the-counter drugs? (select all that apply)

They do not require the supervision of a nurse is correct. Over-the-counter drugs do not require a prescription or the supervision of a nurse.They can interact with other drugs is correct. Many over-the-counter drugs interact with other drugs.They should be included in the client's drug history assessment is correct. Over-the-counter drugs are often omitted from the drug history assessment, but they should be included. Nurses should ask specific questions about over-the-counter drugs and herbal remedies.

A nurse is teaching a client who has a prescription for a drug that has a receptor agonist effect. Which of the following information should the nurse include

This will increase the effects of normal cellular function.

The nurse is caring for a patient receiving intravenous gentamicin for a severe bacterial infection. Which assessment finding by the nurse indicates the patient is experiencing an adverse effect of gentamicin therapy?

Tinnitus

A nurse is preparing to teach a client about a newly prescribed drug. Prior to providing teaching, the nurse should review the precautions section of a drug handbook for which of the following reasons?

To determine if dosage modification is indicated The precautions section includes diseases or clinical situations in which drug use involves particular risks or dosage modification might be necessary, such as the presence of a client condition or restrictions due to the client's age.

Which therapeutic use is for Metronidazole?

Trichomoniasis

A nurse is caring for a client who has a new prescription for a drug. After receiving the first dose of the drug, the client experiences anaphylaxis. The nurse should identify that anaphylaxis represents which of the following results of the drug?

adverse effect

You are talking with a patient about taking tetracycline along with an antacid. You tell the patient not to take these two drugs at the same time because the antacid can reduce the absorption of tetracycline. When one drug reduces the effect of another drug, it is

an antagonistic effect.

Digoxin has a half-life of 36 to 48 hours. Because of the length of the half-life, the nurse expects dosing to occur how often?

once a day

Which of the following interventions should you implement to prevent a serious adverse reaction in patients receiving IV acyclovir (Zovirax)?

increases fluid intake

a nurse is preparing to administer a drug to a client. in which of the following sections of a drug handbook should the nurse look to determine if the drug has more than one use

indications

When reviewing a list of drugs in a drug handbook, a nurse can identify the generic name for a drug in which of the following ways?

it begins in a lower case letter

When a drug is being used for an indication other than what is was approved for by the FDA, it is referred to as ________________________________ use.

off label